PRIVACY STATEMENT

This notice describes how information about you may be used and disclosed and how you can get access to this information.

The Board of the Southern California IBEW-NECA Health Trust Fund is sensitive to your concerns about privacy.  This privacy notice describes how we use and protect personal information, referred to as "member information". It will help you understand how we treat the member information that we obtain from you or other sources in the course of providing you with products and services.

When you are conducting business with Southern California IBEW-NECA Retiree Health Trust Fund under the Retiree Health Plan, you can have confidence that we respect your privacy and that we will protect the information that we may obtain about you. At Southern California IBEW-NECA Retiree Health Trust Fund:

• The Retiree Health Plan has established physical, electronic, and procedural safeguards to protect member information. All personnel within Southern California IBEW-NECA Retiree Health Trust Fund are trained and reminded of the importance of protecting member information.


• The Retiree Health Plan demands any persons or businesses that provide services on our behalf to keep member information confidential and to use it only to provide the services we’ve asked them to perform.


• The Retiree Health Plan does not sell your member information.


• The Retiree Health Plan does not share member information with persons, companies, or organizations outside of Southern California IBEW-NECA Retiree Health Trust Fund that would use the information to contact you about their own products and services.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to request a restriction on certain uses and disclosures of your information. You have the right to request to inspect and obtain a copy of your health information, to obtain an accounting of disclosures of your health information, to request communications of your health information by alternative means of at alternative locations and to revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

The Board of Trustees of the Southern California IBEW-NECA Retiree Health Trust Fund is required to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to information the Retiree Health Plan collects and maintain about you. The Retiree Health Plan must abide by the terms of this notice, notify you if the Retiree Health Plan is unable to agree to a requested restriction, and accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations. The Retiree Health Plan reserves the right to change its practices and to make the new provision effective for all protected health information we maintain. Should its privacy practice change, the Retiree Health Plan will mail a revised notice to the address you’ve supplied it with. The Retiree Health Plan will not use or disclosure your health information without your written authorization, except as described in this notice. You may revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Examples of Disclosures for Treatment, Payment, and Health Operations

HMO’s may use your health information for treatment. For example: information obtained by a nurse, physician, or other member of your healthcare team may be recorded in you record and used to determine pre-authorization for service or treatment by a healthcare provided under the terms of your policy.

HMO’s may use your health information for payment. For example: An Explanation of Benefits (EOB) may be sent to a third-party payer to coordinate payment of claims. The information on or accompanying the EOB may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

Business Associates: There are some services provided in our organization through contracts with business associates. When these services are contacted, the Retiree Health Plan may disclose your health information to our business associate so that they can perform the job the Retiree Health Plan has asked them to. To protect your health information, however, the Retiree Health Plan requires the business associate to appropriately safeguard your information.

Public Health: As required by law, the Retiree Health Plan may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law Enforcement: The Retiree Health Plan may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney provided that a Southern California IBEW-NECA Retiree Health Plan staff member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional standards.

How the Retiree Health Plan Obtains Member Information

Some of the member information that we collect comes directly from you. When submitting your application for Retiree Health Plan enrollment, you may give us information such as your name, address, and Social Security number.

What the Retiree Health Plan Does With Your Member Information

The Retiree Health Plan uses member information to provide health and welfare services to you. It may, without authorization but only as permitted or required by law, provide member information to persons or organization both inside and outside of the Southern California IBEW-NECA Retiree Health Trust Fund in order to handle and/or investigate claims, fulfill a transaction you have requested, service your policy, detect and/or prevent fraud, participant in insurance support organizations, or comply with lawful requests from regulatory and law enforcement authorities.

How Does the Retiree Health Plan Protect Your Member Information?

Member information administered by the Southern California IBEW-NECA Retiree Health Trust Fund is only available to those individual who need to see it to fulfill and service your needs. All employees and agents of the Southern California IBEW-NECA Retiree HealthTrust Fund are instructed on the need to protect member information. In addition, the Retiree Health Plan has established legal agreements with companies working on Southern California IBEW-NECA Retiree Health Trust Fund’s behalf that require them to protect member information and to use that information only to provide the service the Retiree Health Plan has asked them to perform. Should your relationship with the Southern California IBEW-NECA Retiree Health Trust Fund end, your member information will remain protected in accordance with our privacy practices as outlined in this Privacy Notice.

How Can You Find Out What Information the Retiree Health Plan Has About You?

You may request to either see, or obtain from the Retiree Health Plan by mail, the member information about you in its records. If you believe that information is incomplete or inaccurate, you may request that the Retiree Health Plan make any necessary corrections, additions or deletions to the disputed member information. You may also request a more complete description of the entities to which the Retiree Health Plan discloses member information, or the circumstances which might warrant such disclosures. Please send any of the requests listed above in writing to:

Southern California IBEW-NECA Health Trust Fund
Post Office Box 910918
Los Angeles, CA 90091

If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer as indicated below:

George Wallace, Administrator
Southern California IBEW-NECA Health Trust Fund
Post Office Box 910918
Los Angeles, California 90091

You may also file a complaint with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.